鲶鱼效应

很久以前，挪威人喜欢吃沙丁鱼，市场上活鱼的价格高出死鱼的好多倍，渔民为了让娇贵的沙丁鱼在长途运输后，不会因为不适应死去，在装满沙丁鱼的鱼槽里放进了一条以鱼为主要食物的鲶鱼，鲶鱼进入鱼槽后，由于环境陌生，便四处游动。沙丁鱼见了鲶鱼十分紧张，左冲右突，四处躲避，加速游动，从而保证了沙丁鱼欢蹦乱跳地回到渔港。这就是著名的“鲶鱼效应”。     

民营医院的“鲶鱼效应“

据说,一艘远洋船队奉命运输一批活的沙丁鱼到另一个国家。由于天气炎热、路途遥远、饵料不足,整个货舱里的沙丁鱼都昏昏欲睡、生死垂危。如不采取措施,这批沙丁鱼必死无疑。这时,聪明的厨师长将几十条准备给船员吃的活鲶鱼分别放入沙丁鱼箱内。奇迹顿时出现了:一条鲶鱼搅活了一     

外资医院:鲶鱼身份

有一则关于鲶鱼的故事:一家捕捞船队为了防止不喜欢游动的沙丁鱼在长途运输中死亡而失去鲜味,在每个水槽中放进了一条鲶鱼。原本懒洋洋的沙丁鱼一看见“天敌”在侧旁游弋,立即感到生存威胁,使出浑身解数拼命游动,以逃避鲶鱼的攻击。于是,整个水槽的鱼都被激活了,靠岸时鱼的成活率大大提高。外资医院目前在中国医疗市场上扮演的角色正如“鲶鱼”一样,起到的仅仅是搅动市场促使公立医院改革的作用。     

“鲶鱼效应”在病区管理中的应用

目的 探讨激发护士潜能，提高组织绩效的模式。方法 利用“鲶鱼效应”理论，发现并合理运用“鲶鱼”，运用鲶鱼效应影响全科护士的思想和行为，实施2年后观察其效果。结果 实施“鲶鱼效应”管理后患者满意度由管理前的90％提高到99．5％，护士自信度由70％提高到95％，护理质量、护理论文书写，护理科研等管理绩效全面提高。结论 合理应用“鲶鱼效应”管理，有助于激发护士潜能的发挥，遗稿管理绩效。     

“鲶鱼效应”在现代图书馆管理中的应用

在阐述"鲶鱼效应"的概念及图书馆引入"鲶鱼效应"必要性的基础上,分析了图书馆管理引入"鲶鱼效应"的意义,并提出将"鲶鱼效应"应用于现代图书馆管理应用"鲶鱼效应"的具体措施.     

好企业不靠经营之神

日本有很多“经营之神”，从松下电器的松下幸之助，到索尼的盛田昭夫；从本田汽车的本田宗一郎，到京瓷的稻盛和夫。     

WHO西太区与“世界中医药学会联合会”中医名词术语国际标准比较研究：精、神、气、血、津、液部分

精、神、气、血、津、液是中医理论中6个非常重要的概念，有关术语在《WHO西太区传统医学国际标准名词术语》中一共收录了59条，“世界中医药学会联合会”（以下简称世中联）《中医基本名词术语中英对照国际标准》中收录了58条。血、津、液的内涵较为具体，有一定的物质基础，理解并不困难。翻译上虽有差异，但亦不难统一。精、神、     

中医药治愈异位性皮炎2例

中医药治愈异位性皮炎２例宫崎纯一杜金行，史载祥（中医心肾科）异位性皮炎（ａｔｏｐｉｃｄｅｒｍａｔｉｔｉｓ，ＡＤ）多发于婴幼儿、青少年，是一种体质性或遗传过敏性湿疹。由于各种因素迁延至成年未愈的病例很多，在日本发病率也很高。现将用中医药治愈的２例日本神...     

五脏神与足太阳膀胱经的紧密联系探析

五脏神,即魂、神、意、魄、志,是精神的一部分,分别寄存于五脏之中。情志过极会造成五脏神的功能紊乱,从而引发躯体疾病。五脏神与足太阳膀胱经联系紧密,足太阳膀胱经结于命门以载神,调节卫气以御神,温通阳气以养神,联系大脑以调神,交通心肾以摄神。膀胱经的腧穴可有效调控五脏神的功能,为情志病的临床治疗提供新的思路。     

“神”的有关问题探讨

神，和生命一样，也产生于先天之精气，《本神篇》云：“故生来谓之精，二精相搏谓之神”。这就指出了神的产生根源。它产生于父母的生殖之精。在阴阳交媾，二精相搏形成生命之际，神也就随之而产生了。可以认为，没有神的产生，也就不可能赋予形以生命，只有神与形俱，才是一个完整的生命。故《天年篇》又云：“人始生……以母为基，以父为栅，失神者死，得神者生”。     

Psychologic distress and QOL in medical staff after a disaster: A longitudinal 4-year study

Aiming to improve post-disaster care of medical staff, we conducted an early and ongoing assessment of post-disaster psychologic distress and quality of life (QOL) in one center of a disaster-response hospital. Twelve days after the Great East Japan Earthquake, as the Fukushima Daiichi Nuclear Power Plant crisis was unfolding, we began a survey to examine the physical and mental state of medical staff to assess their motivation toward work. Surveys were administered in March 2011 (Survey 1), March 2012 (Survey 2), March 2013 (Survey 3), March 2014 (Survey 4), and March 2015 (Survey 5). Participants completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), EuroQol (EQ-5D), and MOS Short-Form 36-item Health Survey (SF-36). Although BDI scores significantly improved over time following Survey 1, participants in their 30s had significantly higher Survey 2 scores than those in their 40s/50s, and significantly higher Survey 3 scores than those in their 20s. STAI scores significantly improved over time following Survey 1. However, participants in their 30s had significantly higher Survey 3 scores than those in their 20s. EQ-5D scores did not significantly vary among survey time points or age groups. SF-36 physical functioning, role physical, social functioning, role emotional, and mental health subscale scores significantly improved over time. In conclusion, post-disaster longitudinal changes, including recovery period, differed among age groups. Thus, age should be taken into account in longitudinal evaluations of psychologic distress and QOL in medical staff after a disaster and, as more recent events suggest, during a pandemic.     

中国人和日本人营养现状的比较分析

本文就1982年我国第二次全国营养调查资料和日本1983年的全国营养调查资料进行了初步的整理和分析。由于我国人民传统的饮食生活习惯和其它一些原因,使我国人民目前的膳食结构不尽合理。主要表现在优质蛋白质、钙、维生素 B_的摄入量低下,碳水化合物与钠的摄入量偏高。维生素 A、B_1、C、尼克酸和铁等营养素摄入量与机体实际吸收利用量不相符,因此营养缺乏病患病率偏高。在每日的膳食结构中,以植物性食物为主要食物。而日本人的膳食结构较我国合理。除钙的摄入量稍显不足外,其余营养素均较充裕。但由于其饮食生活的西欧化,同时也代来了营养过剩等问题。     

An American hibakusha in Fukushima

A magnitude 9.0 earthquake and tsunami originating off the east coast of Japan triggered the explosive release of radioactive isotopes from one of four nuclear power plants in the affected area. This event has been compared with the 1986 nuclear accident at Chernobyl, the 1945 atomic bombing of Hiroshima and Nagasaki, and the intervening era of atmospheric nuclear weapons testing. The credibility of any comparison depends on the source, for which reason various specialists were invited to address an audience of media, healthcare, and disaster response professionals on July 18, 2011 in Fukushima City, Fukushima Prefecture. This article is based on a presentation given July 18, and interprets the Fukushima nuclear crisis from the perspective of an American doctor who grew up downwind of an atomic bomb test site, and who now works at Fukushima Medical University.     

地震后心理危机干预的介入刍议

目的对地震后心理危机干预的介入进行探讨,为地震后心理危机干预的介入提供科学依据。方法四川5．12大地震后心理救助实际经验结合理论进行分析。结论地震后的心理危机干预,在地震灾难后的急性应激阶段介入能够取得较好的效果,同时需要考虑相对后方的介入地点和生命安全得到保证,生理需要得到基本满足的介入人群。心理危机干预介入的措施包括心理支持和陪护、放松技术、心理宣泄以及严重事件晤谈。     

研究生心理危机三级预防干预机制构建探析——以北京大学医学部为例

长久以来人们普遍认为高学历的人必然具有良好的心理素质，因此研究生心理危机预防干预一直不被社会及教育者们重视。文章以北京大学医学部为例，对研究生的心理健康状况及心理危机预防干预现状进行了介绍，对在研究生中构建心理观察员一班主任、辅导员一心理咨询中心的研究生心理危机三级预防干预机制进行了积极地探索与思考。     

不同胰岛素注射方式治疗非昏迷高血糖危象患者的疗效研究

背景高血糖危象是糖尿病的急危重症，治疗上体现个体化，降糖使用的胰岛素为小剂量静脉滴注，但相关研究指出全程使用胰岛素皮下注射泵同样能起到小剂量胰岛素静脉注射泵的效果，且使用更加简易方便。目的探讨治疗非昏迷高血糖危象患者时使用小剂量胰岛素静脉注射泵及胰岛素皮下注射泵的血糖缓解情况。方法选取2017年3月至2020年3月于广州市红十字会医院住院治疗的高血糖危象患者115例，其中糖尿病酮症酸中毒（DKA）72例，高渗高血糖综合征（HHS）43例。采用随机数字表法将患者分为小剂量胰岛素静脉注射泵组（n=58）及胰岛素皮下注射泵组（n=57）。小剂量胰岛素静脉注射泵组使用重组人胰岛素，胰岛素皮下注射泵组使用门冬胰岛素，患者血糖达标前，两组胰岛素用量均为0.10~0.15 U·kg-1·h-1。观察两组患者血糖下降速度、血糖达标时间、平均血糖及低血糖发生次数。结果小剂量胰岛素静脉注射泵组和胰岛素皮下注射泵组血糖下降速度、血糖达标时间、平均血糖、低血糖发生次数比较，差异均无统计学意义（P>0.05）。小剂量胰岛素静脉注射泵组和胰岛素皮下注射泵组中的DKA患者血糖下降速度、血糖达标时间、平均血糖、低血糖发生次数比较，差异均无统计学意义（P>0.05）。小剂量胰岛素静脉注射泵组和胰岛素皮下注射泵组中的HHS患者血糖下降速度、血糖达标时间、平均血糖、低血糖发生次数比较，差异均无统计学意义（P>0.05）。结论对于非昏迷高血糖危象患者，使用小剂量胰岛素静脉注射泵及胰岛素皮下注射泵均可有效缓解血糖，胰岛素皮下注射泵可作为高血糖危象患者降糖的注射方式之一。     

“海恩法则”对大学生心理危机管理的启示

近年来,存在心理危机的大学生群体越来越大,给社会、家庭和学校造成一定压力,大学生心理健康问题正在被越来越多的人关注。“海恩法则”指出,任何不安全事故都是可以预防的,这对大学生心理危机管理以诸多启示：高度重视和建立大学生心理危机管理工作制度;建立大学生心理危机管理组织机构和心理危机干预队伍;完善高校大学生心理危机管理预案制度;构建大学生心理危机预警机制;心理危机干预走专业化道路;加强心理危机恢复管理。     

Demographics, aging and health care: is there a crisis?

Will the aging of Canada's population bankrupt the health care system? In this issue (see pages 1555 to 1560) Dr. Marie Demers reports that the increase in physician service costs for elderly people in Quebec from 1982 to 1992 resulted primarily from increased utilization and only secondarily from the growth of the elderly population. In this editorial the author argues that the common perception that masses of elderly people will soon swamp the system deflects attention from the crucial issue of utilization. Although a wide range of interventions for elderly people have demonstrable benefits, more research is needed to ensure that intensified services, especially for elderly people in good health, are effective and well targeted. It is not the aging of our population that threatens to precipitate a financial crisis in health care, but a failure to examine and make appropriate changes to our health care system, especially patterns of utilization.     

Comprehensive medication management services influence medication adherence among Japanese older people

Objective: Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan.Methods: Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (p-value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI).Results: Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99).Conclusion: Receipt of comprehensive medication management services for older people was associated with medication adherence.